The objective of this proposal is to build on previous successful collaborations between (Cornell) researchers from Weill Medical College of Cornell University (formerly known as Cornell University Medical College), the Haitian Study Group on Kaposi's Sarcoma and Opportunistic Infections (GHESKIO), the Haitian Red Cross, and the Haitian Ministry of Health to develop a national blood safety program for Haiti, which may serve as a model for blood safety programs in other developing countries. Studies by Cornell-GHESKIO researchers in 1983, during the early stages of the HIV epidemic in Haiti, demonstrated that 40% of the HIV infected women in Port- au-Prince had received a blood transfusion. Cornell-GHESKIO researchers identified a for-profit blood bank as a source of many of these transfusions. Based upon this information, the Haitian Ministry of Health closed the for-profit blood bank in 1986, and placed the Haitian Red Cross in charge of blood safety in Haiti. In 1988, with the assistance of a Fogarty training grant, Cornell-GHESKIO researchers trained the administration and technical staff of the Haitian Red Cross in blood safety testing. The Haitian Red Cross, with on-going technical advice from Cornell-GHESKIO researchers, continues to monitor blood safety in Port-au-Prince. The current proposal aims to solidify the training of the Haitian Red Cross in Port-au-Prince and to expand their activities to rural Haiti where 70% of the population lives. The highest priority will be given to the training of personnel directly involved in blood banking operations (laboratory technicians, counselors and data entry staff), as well as physicians who are most likely to use blood products (obstetricians and surgeons). In addition, the general public will be educated and encouraged to give regular blood donations and to avoid paid donors. The current proposal also aims to address several areas of research of importance for blood safety in Haiti: 1) determine the prevalence rate and risk factors for infection with blood borne pathogens among blood donors in urban and rural Haiti including HIV-1, HIV-2, HTLV-1, HCV, HBV, syphilis, and malaria; 2) determine the prevalence and risk factors among blood donors of HIV-infected individuals in the "window period", the time between HIV infection and development of HIV antibodies detectable by standard ELISA assays.